RU97120762A - CUTTING GUIDE TOOL, METHOD FOR HIGH-PRECISE RESECTION OF THE HEAD OF THE FEMORAL NECK AND THE APPLICATION OF THE TOOL - Google Patents

Claims (1)

1. A cutting guide tool for providing high-precision resection of the head (8) of the human neck (5) of the femur (femoral neck) at a predetermined cutting angle (α _c ) to the femoral shaft 9 and at a predetermined cutting level (L _c ) relative to the near the end of the head (8), characterized in that it contains a support part (11), including a fastener (14), fixed in the femur during resection, a longitudinal guide bearing element (12), which when using the tool is supported by the support Tew (11) and extends along the femoral collum (5) at a predetermined cutting angle (α _c) to the shaft (9) of the femur, and a cutting guide (13) which is supported by the guide carrier element (12) and is movable along its axis (DD) to the cutting position (place) corresponding to a predetermined cutting level (L _c ). 2. The tool according to claim 1, characterized in that the guide bearing element (12) is rotatably supported by the supporting part (11) for its angular movement around the axis of rotation (CC), passing across the plane of symmetry (M) of the femur for ensuring installation of the guide bearing element (12) at a predetermined cutting angle (α _c ) to the trunk (9) of the femur. 3. The tool according to claim 2, characterized in that it further comprises a device for setting the reference angle (40), which is equipped with a relatively long rod mounting element (44) extending across the axis of rotation (C - C) of the guide bearing element (12) having the ability to connect with the supporting part (11) with the possibility of rotation for angular movement around the axis of rotation (C - C) of the guide bearing element (12) in the angular position, in which the rod mounting element (44) is essentially parallel to ox (9) of the femur, the angle between the guide carrier element (12) and the shaft alignment part (44) is equal to the predetermined cutting angle (α _c), when the cutting guide (13) is located at a position (place) of the cutting head.  4. The tool according to p. 3, characterized in that the guide bearing element (12) and the device for setting the reference angle (40) are able to rotate independently of each other around the axis of rotation (CC) of the guide bearing element (12) and are equipped with indicating means (41, 42, 46) for visual indication of the angle between the guide bearing element (12) and the installation element (44).  5. The tool according to any one of paragraphs. 2-4, characterized in that it further comprises means for fixing the cutting angle (30 -32) to prevent the angular movement of the guide bearing element (12) around the axis of rotation (CC).  6. The tool according to any one of paragraphs. 1-5, characterized in that the guide bearing element (12) has the ability to offset across the support part (11) in a direction parallel to its axis of rotation (C - C) to adjust the distance between the cutting guide (13) and the femoral neck (5) .  7. The tool according to any one of paragraphs. 1-6, characterized in that it further comprises a locking means (57) for locking the cutting guide (13) to prevent its movement along the axis of the guide bearing element (12).  8. The tool according to any one of paragraphs. 1-7, characterized in that the cutting guide (13) is made rotatable around the axis (D-D) of the guide bearing element (12).  9. The tool according to any one of paragraphs. 1-8, characterized in that the cutting guide (13) is fixed in its cutting position on the part of the femur, which must be removed.  10. A tool according to claim 9, characterized in that the cutting guide (13) has one or more channels (51) into which fastening means are inserted, such as nails (58) for fixing the cutting guide (13).  11. The tool according to any one of paragraphs. 1-10, characterized in that the fastening element (14) of the supporting part (11) is a nail (14), designed for temporary fixation in the femur.  12. The tool according to claim 11, characterized in that the nail (14) is driven into the upper part of the femoral neck (into the trochanteric fossa) in the direction of the trunk (9) of the femur, the nail (14) has a length sufficient to extend inside the barrel (9) The femur was guided by this trunk.  13. The tool according to any one of paragraphs. 1-12, characterized in that the supporting part (11) further comprises a console (22), which is detachably connected to the fastener (14) in its first end part (25) and supports the guide bearing element (12) in its second end part (26).  14. The tool according to any one of paragraphs. 1-13, characterized in that the supporting part (11) further comprises a neck alignment element (19), such as a rod, which is located in the symmetry plane (M) of the femoral neck for installing the guide bearing element (12) in the direction parallel to this plane of symmetry (M).  15. The tool according to any one of paragraphs. 1-14, characterized in that the guide bearing rod (12) is equipped with a stop lever (53) extending to the side from the guide bearing element (12) and moved all the way to the proximal end of the head (8), and in which the guide bearing element (12) ) and the cutting guide (13) are equipped with a position indicator (54 - 56) to visually indicate the distance between the cutting guide (13) and the stop lever along the axis (D - D) of the guide bearing element (12).  16. The tool according to p. 15, characterized in that the guide bearing element (12) is movable in its longitudinal direction relative to the support part (11) to move the stop arm (53) to its stop at the proximal end of the head (8).  17. The tool according to any one of paragraphs. 1-16, characterized in that the cutting guide (13) has a slot (50) for receiving and guiding the cutting knife or its equivalent. 18. The method of high-precision resection of the head (8) of the neck (5) of the human femur (femoral neck) at a predetermined cutting angle (α _c ) to the trunk (9) of the femur and at a predetermined cutting level (L _c ) relative to the proximal end of the head (8), characterized in that the longitudinal support element (12) is installed along the femoral neck (5) at a predetermined cutting angle (α _c ) to the trunk (9) of the femur, use a cutting guide (13), which is supported by a guide bearing element (12) and is movable along its axis (D - D) and ne move the cutting guide (13) along the guide bearing element (12) to the cutting position (place) corresponding to a predetermined cutting level (L _c ).  19. The method according to p. 18, characterized in that it further includes the steps of using the support part (11), which supports the longitudinal guide bearing element (12), and attaching the support part (11) to the femur during resection of the head. 20. The method according to p. 19, characterized in that the guide bearing element (12) is pivotally supported by a support part for angular movement around the axis of rotation (CC) extending across the plane of symmetry (M) of the femur, and the rotation of the guide bearing element ( 12) around the axis of rotation (C - C) at a predetermined cutting angle (α _c ) to the trunk (9) of the femur, carried out after the stage of attachment of the supporting part (11) to the femur. 21. The method according to p. 20, characterized in that the rotation of the guide bearing element (12) around the axis of rotation (CC) by a predetermined cutting angle (α _c ) includes the installation of a relatively long mounting element (44) connected to supporting part (11) for its rotation around the axis of rotation (C - C) and used as an element to set the reference angle, essentially parallel to the trunk (9) of the femur, the angle between the guide bearing element (12) and the relatively long mounting element ( 44) will be equal to a predetermined the cutting angle (α _c ) when the cutting guide (13) is in its cutting position.  22. The method according to p. 21, characterized in that the alignment of the relatively long installation element (44) mainly parallel to the trunk (9) of the femur includes the operation of turning the installation element (44) in a position in which its outer end is located against the corresponding knee joint, preferably against the patella. 23. The method according to any one of paragraphs. 20 - 22, characterized in that it further includes the step of locking the guide bearing element (12) to prevent its angular movement around the axis of rotation (CC), carried out after the stage of rotation (installation) of the guide bearing element at a predetermined cutting angle (α _c ).
24. The method according to any one of paragraphs. 18-23, characterized in that it further includes fixing the cutting guide (13) relative to the guide bearing element (12), carried out after the stage of moving the cutting guide (13) to the cutting position of the head.  25. The method according to any one of paragraphs. 18-24, characterized in that it further includes the step of securing the cutting guide (13) on the part of the femur to be removed by resection, carried out after the stage of moving the cutting guide (13) to the cutting position, but before resection of the head.  26. The method according to any one of paragraphs. 18-25, characterized in that the stage of attachment of the supporting part (11) includes a substation of temporary fastening of the nail (14) in the femur.  27. The method according to p. 26, characterized in that the nail (14) is driven into the upper part of the femoral neck (in the trochanteric fossa) in the direction of the trunk (9) of the femur.  28. The method according to p. 26 or 27, characterized in that the length of the nail (14) is chosen so that it is sufficient for it to pass into the trunk (9) of the femur and its direction using this trunk.  29. The method according to any one of paragraphs. 18-28, characterized in that the alignment of the guide bearing element (12) along the femoral neck (5) includes the location of the guide bearing element (12) parallel to the plane of symmetry (M) of the femoral neck (5). 30. The use of a cutting guide tool according to any one of paragraphs. 1 -17 for highly accurate resection of the head (8) of the neck (5) of the human femur (femoral neck), in which the supporting part (11) is attached to the femur with the help of a fastener (14), the guide bearing is placed along the femoral neck ( 5) at a predetermined cutting angle (α _c ) to the trunk (9) of the femur, the cutting guide (13) is moved along the axis of the guide bearing element (13) to the cutting position (location) corresponding to a predetermined cutting level (L _c ) relative to near end holo windings (8), and the head (8) are cut at a predetermined cutting angle (α _c ) and at a predetermined cutting level (L _c ) using a cutting element (tool) guided by the cutting guide (13).